Brendan Ryan (Labour)

I gently take issue with Senator Lydon. The Minister of State would probably agree with me that perhaps as good a model of an excellent centre of care for the elderly is St. Vincent's Hospital in my home town of Athy, which happens to be where my mother resides. It would be remiss of me not to put on the record the extraordinary quality of care available which I am sure is replicated in many public facilities for older people throughout the country. It is a remarkably good humoured, cheerful place and it provides high-quality personal and medical services. Families are integrated and it is easy to get access. It provides an extremely good service.

I am a little worried that the Tánaiste and Minister for Health and Children may be allowing her preference for the private sector to direct her funds in the direction of private nursing homes rather than towards the expansion of public sector care for the elderly. If one wants a model of how good public provision can be, many of the public services provided for elderly people provide such a model.

What was announced in the budget is a considerable improvement but it is, to a degree, symptomatic of something which seems to be a particular blind spot with the Government, that is, the realisation that there are costs associated with prosperity. We have moved from a situation where there were 1 million people at work in 1996 to one where there are 2 million at work now. The population has not increased by anything like that number and it is also ageing. Many services were provided by volunteers or by the considerable number of people who were underemployed or who were not employed and who were often women. As I have said 100 times here, I would rather have the problems we now face than those we had in the past.

However, there was a great need for a strategic realisation that as our labour force expanded and as people's free time, therefore, contracted, gaps would appear all over the place in the network of community support which used to exist. I noted a reference to the increased funding for meals on wheels in the Minister of State's contribution, which I welcome. However, a problem about which people doing meals on wheels in Cork have told me is that the providers of the service are ageing and the number of volunteers is declining because people who used to volunteer — very often married women whose children were in school — are working, and who would begrudge them that. It is beginning to leave gaps all over the place in services. That is an issue which we, as a society, and the Government, as the lead player in society, will have to address, that is, it is no longer possible to do the things we could do through voluntary service in the past. I am not suggesting the goodwill has changed but people have changed and opportunities have presented themselves. We are in a completely new environment.

The fundamental fact in all of this is that as a percentage of GDP, our expenditure on protection of the elderly is low by international standards. We must realise that with prosperity of the scale this country has achieved, we are beginning to be forced into choices. I refer to the famous comparison the Tánaiste said she never really made between Boston and Berlin but which has become part of our political mythology. We are liable, by default, to make the choice of the Boston rather than the Berlin model which leaves people to provide for themselves out of their own resources and creates a profoundly unequal society. If we do not strategically decide to direct public resources to reduce those inequalities, we will end up with an impoverished older population which is in considerable danger of poverty. Some 7% of old people live in conditions of consistent poverty, according to the most recent Central Statistics Office figures.

We are creating a network, or a patchwork, of gaps which will impoverish older people. What happens to an old person on an non-contributory old age pension if his or her waste service is provided by a private operator and for whom there is no waiver, as happens in many parts of the country? If an old age pensioner moves from inside to outside the city boundary in Cork, he or she suddenly discovers the waiver he or she had is gone. I am sure the Minister of State can usually manage the payment of waste charges, whatever about myself. However, for an old person on an income of €200 or €250 per week, the annual charge for waste disposal is the equivalent of one week's income. That is a hole in anyone's budget.

The Government must see old people as in need of a variety of services, the most fundamental being that they have an adequate income which they can spend on the things they need and which is not extracted from them by increased local authority rents, the imposition of privatised waste collection charges or by a sudden increase in energy costs. I am glad the Government has decided to increase the fuel allowance for the first time in I do not know how many years.

Some 31% of our elderly people suffer from a disability, that is 135,000 people. Have we a strategy in place? I know we have the beginnings of something. Again, I do not want to play a silly negative game. Everything done in the budget is welcome and is better than nothing. However, one would have a greater sense that there was a strategic plan if there was not the slippage in respect of the nursing homes inspectorate. The legislation was supposed to have been introduced in the autumn. As we approach 2006, it has still not emerged and we do not know when it will.

The same applies to the repayments of the illegal charges. A cynic would say people are waiting for as many as possible of those charged illegally to die because it is probably more difficult for the dead to sue than for the living. It is also probably more difficult for the beneficiaries of a will to sue than for a living individual to do so. I cannot understand the slowness of this, whatever about the merits or demerits of it because I did not have a serious problem with people paying a reasonable fee towards good quality care. This is a strategic failure on the part of a number of Governments, including some in which my own party participated. I support the Fine Gael amendment because it identifies the need for a strategy. What we have here is an indication of what may be a strategy but I would like to see it in its entirety not just little examples of it. Then we could believe there was a coming together of all the agents of the State to provide the type of quality of life to which our older people are entitled.